Pattern of Drug Resistant Helicobacter Pylori in Dyspeptic
Patients in Thailand
NATHAYA TANGMANKONGWORAKOON, MD*, VAROCHA MAHACHAI, MD*,
DUANGPORN THONG-NGAM, MD**, RATHA-KORN VILAICHONE, MD*,
SOMYING TUMWASORN, PhD***, PINIT KULLA VA NUA YA, MB, ChB*
Affiliation : * Gastroenterology Unit, Department of Internal Medicine,
**Department of Physiology,
*** Department of Microbiology, Faculty of Medicine, Chulalongkom University Hospital, Bangkok I 0330, Thailand.
AbstractEmergence of drug resistant Helicobacter pylori (H. pylori) has occurred in various countries
and could compromise the efficacy of current treatment regimens. The aim of the study was to iden
tify the pattern of antibiotic resistant H. pylori in Thailand and evaluate various factors associated with
drug resistance. Between June 2001 and December 2002, a total of 560 dyspeptic patients who under
went upper gastrointestinal endoscopy at King Chulalongkom Memorial Hospital were included in this
study. Antral gastric biopsies were obtained for H. pylori cultures and susceptibility tests using Epsilo
meter test (E-test). The value of antibiotic resistant breakpoints were amoxicillin 0.5 J..tg/ml, clarithro
mycin 1.0 J..tg/ml, metronidazole 8 J..tg/ml, and tetracycline 4J..tg/ml, respectively. H. pylori were detected
in 315 patients using the rapid urease test (56.25% ). Cultures for H. pylori were positive in 172 patients.
E-test for all four antibiotics was successfully placed in 79 isolations. The prevalence of antibiotic
resistant H. pylori were amoxicillin 13.9 per cent (11/79), clarithromycin 19.0 per cent (15/79), metro
nidazole 30.4 per cent (24/79), tetracycline 5.1 per cent (4/79), and multi-drugs 16.5 per cent (13/79),
respectively. However, age, sex, or endoscopic findings did not differ between the patients with H.
pylori resistant strains and sensitive strains. The emergence of antibiotic and multi-drug resistant H.
pylori in Thailand were relatively high and these could compromise the efficacy of current treatment
regimens. The factors associated with drug resistant H. pylori could not be demonstrated in the pre
sent study. Further study in a larger number of patients might be necessary to identify factors asso
ciated with resistant H. pylori.
Keywords : Helicobacter Pylori, Drug Resistance, Dyspeptic Patients, Thailand
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